1Department of Health Promotion & Behavior, School of Public Health, Georgia State University, Atlanta, GA, USA2Department of Health Promotion, College of Public Health, University of Kentucky, Lexington, KY, USA3Kinsey Institute for Research on Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA4Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, University of Chicago, Chicago, IL, USA5Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA

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Abstract

This study assessed the prevalence of self-reported HIV infection among a community sample of transgender women and identified associated contextual, experiential, and behavioral factors. Ninety-two transgender women completed a self-administered interview. Recruitment occurred through an LGBT service organization, a transgender support group, transgender advocates, and informal communications. Eighty-two percent were African American/Black. Of 83 who knew their status, 60% reported being HIV infected. High rates of childhood sexual abuse (52%), rape (53%), intimate partner violence (56%), and incarceration (57%) were reported. Many did not have health insurance (53%), were not employed full-time nor in school (63%) and had been recently homeless (49%). HIV-infected transgender women as compared to HIV-uninfected transgender women were more likely to be African American/Black (P = 0.04), and older than 34 years (P = 0.01), unemployed/not in school (P P = 0.03), perceived less negative psychosocial impact due to trans status (P = 0.04) and had greater happiness with their physical appearance (P = 0.01). HIV-infected transgender women may experience relatively less trans-related stress compared to their HIV-uninfected counterparts. High rates of HIV, trauma, and social marginalization raise concerns for this population and warrant the development of structural and policy-informed interventions.